| 杜俊杰,栾冠楠,陈宇飞,贾斌,彭页,厉晓杰,马双,罗卓荆.新鲜Ⅱ A型齿突骨折的外科治疗[J].脊柱外科杂志,2016,14(4):230-233. |
新鲜Ⅱ A型齿突骨折的外科治疗  点此下载全文 (Fulltext) |
| 杜俊杰1 栾冠楠2 陈宇飞1 贾斌3 彭页1 厉晓杰1 马双4 罗卓荆5 |
1. 空军总医院骨科, 北京 100142;
2. 中国医学科学院医学信息研究所, 北京 100020;
3. 宝鸡市中医院骨科, 陕西 721000;
4. 黄河三门峡医院骨科, 河南 472000;
5. 西京医院骨科, 陕西 710032 |
| 基金项目：国家自然科学基金（81501929） |
| DOI：10.3969/j.issn.1672-2957.2016.04.010 |
| 摘要点击次数: 869 |
| 全文下载次数: 131 |
| 摘要： |
| 目的 探讨新鲜Ⅱ A型齿突骨折的治疗方法的选择。方法 2006年1月-2012年12月，空军总医院骨科收治新鲜Ⅱ A型齿突骨折13例，其中5例采用Halo-vest支架外固定治疗（外固定组），8例采用前路齿突螺钉内固定治疗（内固定组）。以疼痛视觉模拟量表（VAS）评分、SF-36评分、并发症发生率、融合率作为指标评价疗效。结果 术后2组患者VAS评分较术前均有不同程度降低。内固定组SF-36评分明显高于外固定组。5例外固定组患者术后12周时3例骨折愈合，2例未融合者延长佩戴时间，末次随访时全部骨折愈合。8例内固定组患者术后12周时全部骨折愈合。外固定组发生钉道感染1例，螺钉松动2例，骨折畸形愈合1例。内固定组发生螺钉退出1例。结论 前路齿突螺钉内固定适用于治疗无手术禁忌证的Ⅱ A型齿突骨折，Halo-vest支架适用于有前路齿突螺钉手术禁忌证的Ⅱ A型骨折。 |
| 关键词：齿突尖 脊柱骨折 骨折固定术 |
| Surgical treatment for fresh type Ⅱ A odontoid fractures Fulltext |
| DU Jun-jie1 LUAN Guan-nan2 CHEN Yu-fei1 JIA Bin3 PENG Ye1 LI Xiao-jie1 MA Shuang4 LUO Zhuo-jing5 |
1. Department of Orthopaedics, Air Force General Hospital of PLA, Beijing 100142, China;
2. Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China;
3. Department of Orthopaedics, Chinese Medicine Hospital of Baoji, Baoji 721000, Shaanxi, China;
4. Department of Orthopaedics, Yellow River Sanmenxia Hospital, Sanmenxia 472000, Henan, China;
5. Department of Orthopaedics, Xijing Hospital, Xi'an 710032, Shaanxi, China |
| Fund Project: |
| Abstract: |
| Objective To explore the surgical treatment strategies of fresh type Ⅱ A odontoid fractures. Methods According to Grauer's classification,13 patients with fresh type Ⅱ A odontoid fractures admitted to Air Force General Hospital of PLA hospital during January 2006 to December 2012 were followed up. Five patients were treated with Halo-vest orthosis (external fixation group),and 8 with anterior odontoid screw fixation(internal fixation group). Neck pain visual analogue scale(VAS) score,SF-36 score,complications and fusion rates were employed to evaluate the therapeutic effect in each group. Results The VAS scores decreased in each group after operation. SF-36 score of internal fixation group was higher than that of external fixation group. Three patients in external fixation group obtained fracture healing at postoperative 12 weeks and 2 non-fusioned patients obtained a final fracture healing after prolonged wear of Halo-vest orthosis at the final follow up. All patients in internal fixation group obtained fracture healing at postoperative 12 weeks. Trajectory infection in 1 patients,screw loosening in 2 patients,and malunion in 1 patient in the external fixation group;Screw pullout in 1 patient in internal fixation group. Conclusion Anterior odontoid screw fixation is suitable for type Ⅱ A odontoid fracture patients without surgical contraindication. Halo-vest orthosis is suitable for the type Ⅱ A odontoid fracture patient with surgical contraindication of anterior odontoid screw fixation. |
| Keywords:Odontoid process Spinal fractures Fracture fixation |
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